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目的探讨乳腺癌手术腋窝淋巴结切除时保留肋间臂神经(ICBN)的方法及临床意义。方法162例Ⅰ、Ⅱ、Ⅲa期乳腺癌患者,随机分为2组,实验组(72例)拟行乳腺癌腋窝淋巴结切除术时保留ICBN,对照组(90例)拟行常规手术切除ICBN,2组术后均按乳腺癌临床指引治疗,并对2组进行观察随访。结果实验组及对照组术后发生上肢感觉障碍分别为22.2%及73.3%(χ2=41.80,P<0.01),疼痛的发生率分别为12.5%及31.1%(χ2=7.86,P<0.01),差异有统计学意义;经4~36个月随访均未发生局部复发。结论Ⅰ、Ⅱ、Ⅲa期乳腺癌腋窝淋巴结切除术时保留肋间臂神经可以明显减少术后患侧上肢感觉障碍及疼痛,提高生活质量。
Objective To investigate the method and clinical significance of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection in breast cancer surgery. Methods A total of 162 patients with stage Ⅰ, Ⅱ and Ⅲa breast cancer were randomly divided into two groups. The experimental group (72 cases) was given ICBN for axillary lymph node dissection of breast cancer, while the control group (90 cases) Both groups were treated according to the clinical guidelines of breast cancer, and the two groups were observed and followed up. Results The upper extremity sensory disturbances in the experimental group and the control group were 22.2% and 73.3% respectively (χ2 = 41.80, P <0.01), and the incidences of pain were 12.5% and 31.1% (χ2 = 7.86, P <0.01) The difference was statistically significant; no recurrence occurred after 4 to 36 months of follow-up. Conclusions The preservation of the intercostobrachial nerve during the axillary lymph node resection for stage Ⅰ, Ⅱ and Ⅲa breast cancer can significantly reduce the sensory dysfunction and pain in upper limbs and improve the quality of life after operation.